Cerebral Palsy Osteoporosis, Osteopenia

Cerebral Palsy Osteoporosis and Osteopenia is one of the most common causes of low bone density among children. What does science say?

"Bone density is significantly decreased, and children with CP
often sustain painful fractures with minimal trauma that impair their
function and quality of life. Preventing or improving osteoporosis and
maximizing bone accrual during critical stages of growth will minimize
the future lifelong risks of fractures in children with CP." Bone Density in Cerebral Palsy by Christine Murray Houlihan, MD and Richard D. Stevenson, MD. August 2009 Phys. Med Rehabili Cin N. America.

Diagnosis Of Cerebral Palsy Osteoporosis, Osteopenia in children

Parents should ask their child's physician for a dexa scan if their child has been diagnosed with CP. This recommendation is not new.

1. The July 2007 issue of Pediatr Radiology has an article by Larry A.
Binkovitz and corresponding authors Paul Sparke and Maria J. Henwood
that states in part: (abstract)

"Normal bone mineral accrual requires adequate dietary intake of
calcium, vitamin D and other nutrients; hepatic and renal activation of
vitamin D; normal hormone levels (thyroid, parathyroid, reproductive
and growth hormones); and neuromuscular functioning with sufficient
stress upon the skeleton to induce bone deposition. The presence of
genetic or acquired diseases and the therapies that are used to treat
them can also impact bone health. Since the introduction of clinical DXA
in pediatrics in the early 1990s, there has been considerable
investigation into the causes of low bone mineral
density (BMD) in children. Pediatricians have also become aware of the
role adequate bone mass accrual in childhood has in preventing
osteoporotic fractures in late adulthood.
Additionally, the availability of medications to improve BMD has
increased with the development of bisphosphonates."

2. But even before that: In 1994 N J Shaw, C P White, W D Fraser, and L Rosenbloom published an article in Arch Dis Child about Cerebral Palsy Osteoporosis. Here is their abstract:

"The bone mineral density of the lumbar spine was assessed in
nine non-ambulant children with cerebral palsy combined with
measurements of serum 25-hydroxyvitamin D, parathyroid hormone, and
urinary calcium excretion. Three children with recurrent
fractures received treatment with bisphosphonates for periods ranging
from 12-18 months. All the children demonstrated a severe reduction in
bone mineral density even when
allowance was made for their body weight. There were no consistent
abnormalities of vitamin D or parathyroid hormone status. Three
children had gross hypercalciuria. Each of the children treated with
bisphosphonates demonstrated an increment in bone density " Note:
hypercalciuria denotes an excess of calcium excreted in the urine.

Final thoughts

Parents and care givers should raise this issue with their
child's health care provider and ask if there are ways to improve weight
bearing exercise in their children as early
and as often as possible.